This is the last of four in a series of companion articles and recorded zoom sessions. It is part of our Preparing for Caring Project to build awareness and educate about the importance of handling skills in caring for a baby. Read more about how these ideas play out in practical suggestions.
Our previous posts in our Preparing for Caring series – Safety, Orientation, Comfort, Bonding, and Curiosity, Baby Ball, and Four Surfaces – looked at our underlying principles and how they inform our suggestions about holding and positioning a baby. In this final post, we’ll apply our principles to the moving transitions involved in picking up, putting down, transferring and repositioning a baby.
Agency: A Fundamental Value
Before we dive into specific handling suggestions, we want to make explicit what we lay out in our principles about agency. We define agency as “the ability to make choices, have an impact, take risks and learn from experience.” We believe agency is a given from the beginning, and involves participation, connectivity and interdependence. Participation means showing up and accepting that we are changed by our participation, and that we are effecting change in return – it’s a relational dance that leads to connectivity and interdependence.
Our role as caregivers, we believe, is to respect and nourish a child’s sense of agency (while also supporting our own). Let’s consider what this might mean when we’re moving them through space and changing their position.
Gravity and Space
As land-based earth creatures, our ability to move through space depends on negotiating our body weight in relation to gravity. From an evolutionary perspective, it’s taken hundreds of millions of years for our animal ancestors to develop these skills. And from an individual human perspective, a baby takes a year or more (after “landing” from the fluid, uterine environment) to learn to get up to walking – moving away from the pull of gravity, and to also be able to get back down safely – descending, or falling, into gravity.
Gravity is present at birth and is a fundamental and unassailable reality. We’re proposing that as we handle a baby, as we move them up and down and through space, we can help them develop a healthy bonding to gravity as a primary force. If we take them through pathways that help them become familiar with their new environment and that support their own movement learning, then they have gravity as a lifelong support. If we can model a functional relationship to gravity in how we accompany them as we move them, even better.
Reframing Falling
We often tell parents that we want (and hope they want) their babies to become masterful at falling. Falling skills are movement skills. Being able to get down safely is as important as getting up, and we believe that our getting up skills and getting down skills are coupled to each other and best developed in tandem. This means not putting a baby into upright sitting or standing positions that they cannot get themselves into and out of. Instead we suggest meeting them on their own level, and valuing their incremental process of learning to negotiate gravity. In our experience, this child-led approach leads to a beautiful combination of confidence and caution. This confidence is not reckless or heedless, but led by curiosity and supported by falling choices. And the caution we see is not fear, but an expression of competent assessment skills: measuring space and distance, having a felt sense of one’s own abilities, weighing desire against risk.
Let’s see how these ideas inform some our handling suggestions for specific situations, as well as our advice about what to avoid.
Setting a Baby Down and Picking Them Up
Our suggestion is to set a baby down through their side and from bottom to top, and to pick them up through their side and from top to bottom. Here’s some of our thinking behind these points.
- The pathway for a baby from being held to being put down on their side (and vice versa) offers a three-dimensional rolling experience. A baby registers this three-dimensionality in part through the vestibular mechanism in their inner ear, an important element in their sense of balance. If we move slowly enough that the baby stays oriented during these transitions, we’re supporting their eventual ability to stay oriented in moving up and down on their own, including when they’re falling.
- When we bring a baby down through their side, we give them a chance to anticipate and participate in the transition – they can see where they’re going and prepare to meet the floor (depending on their developmental stage). This is potentially a very different experience from being put down on their backs, when they can’t see where they’re going and the floor suddenly “arrives” – this can be disorienting or startling for a small baby.
- Picking a baby up from top to bottom (so their head comes up before their pelvis), and setting them down bottom to top (so their hip lands first, then their head) models a functional pathway that babies will eventually use to get themselves up to sitting and to find their way back down safely. One of the most important criteria for safe falling is protecting our head by keeping it from hitting the floor (or at least slowing down the impact) – thus the head should be the last thing down.
- We recommend supporting a baby’s head and pelvis during these transitions. This allows us to support the top and bottom of the baby’s midline structures (skull, spine and sacrum), while also keeping the baby’s arms free to meet the floor. In general, we suggest not holding or restricting a baby’s arms when we handle them, so their arms are available to reach out and navigate a fall (which protects their head).
- ‘Putting a baby down through their side’ adapts as a baby’s movement skills develop. We put a small baby all the way down into lying on their side, so that the sequence is hip, shoulder and head. An older baby might land on their hip and then their forearm and then roll themselves onto their tummy. Later a baby might extend their arm and reach an open hand to the floor, and move from here up to sitting, or into crawling. This last stage, where the hand reaches out, involves an important falling reflex called (very descriptively) ‘protective extension.’ For this reason, we recommend that caregivers continue to put their baby down through side even after a baby has learned to sit and stand on their own.
Moving a Baby from Side to Prone, and Prone to Side
Our suggestion is to help a baby get to and from their tummy (prone) through side-lying. Here are our thoughts on why we offer this advice.
- A common concern we hear from parents is that their baby “hates” tummy time. We first invite a reinterpretation: we believe babies are expressing their discomfort (rather than a conscious dislike), and we can move on to helping the baby become more comfortable in prone. In our experience, when we help a baby roll from their side to their tummy, following their timing and initiation, they are often more comfortable when they arrive. How we get into a position can have a big effect on our experience once we’re there – again, paying attention to process and transitions are key.
- Going from side to prone or from prone back to side involves a quarter-roll, which helps familiarize a baby with rolling pathways they’ll eventually learn to master themselves. Even when a baby isn’t doing the movement on their own, these transitions are important opportunities to practice essential rolling (and falling skills), including managing their head.
- Moving a baby in and out of tummy by rolling them (rather than picking them up and putting them back down to reposition them) gives them the continuous feedback of contact with the floor and their weight shifting.
What to Avoid
While we try to stay away from negatives, we have a few key suggestions about ways we don’t recommend handling a baby. We hope we’ve made a case for the positive suggestions that come out of our principles in such a way that it is obvious why we make these “what to avoid” points.
- Don’t pick up a baby under their arms. When held under their arms, most of a baby’s body is hanging in space (rather than gathered in), there’s no orienting support from underneath and the baby’s head is not supported. It makes a baby’s arms unavailable for self-comfort or support, and it can interfere with their breathing because their ribs are held. It also encourages moving a baby through space in an upright (rather than horizontal) position.
- Don’t prop a baby in sitting or standing. As mentioned earlier, we believe babies best learn to move by gradually finding their way to upright positions, which also helps them develop their falling skills. ‘Skillful falling’ means they can stay oriented and support their head when they change levels. A baby who is put in sitting before they can get there themselves will learn to hold themselves there, no doubt. But holding themselves is all they can do: they don’t have the falling skills to change levels and stay oriented and feeling safe. This can leave a baby feeling stuck, upset and over-stimulated, and it doesn’t support their sense of agency.
- Don’t let a baby’s head fall backwards when holding or moving them. A sense of falling back often stimulates a startle or other protective response; it doesn’t support a baby’s sense of safety. Falling backwards, especially head first, is the most dangerous way to fall, and we want babies to eventually learn to respond to falling backward by rolling or otherwise protecting their head. (In addition to what we’ve mentioned above, another reason we recommend setting a baby down through their side rather than their back is so that we don’t inadvertently normalize a backward trajectory through space.)
When we respect a baby’s timing and we value their process, we support them in reaching their milestones with skill, confidence, caution – and an intact sense of agency.
Final Thoughts Our intention in offering these suggestions is to elucidate and educate about how our principles and values play out in practice, for us. We acknowledge that the same principles could lead to different handling suggestions. And while we feel passionately about our principles and values and hope to persuade through articulating them, we don’t assume everyone is fully on board. It’s not our intention to be dogmatic, or to make it about right and wrong. We hope we’ve offered food for thought and perhaps inspiration for others to reflect on how their principles might be put into practice.
Please share this with anyone who might be interested, and let us know what you think.
NOTE: Our ideas are based on the Body-Mind Centering® approach to Infant Developmental Movement Education (IDME), a program developed by Bonnie Bainbridge Cohen, with support from Sandra Jamrog and Lenore Grubinger, that teaches observation and facilitation of movement patterns in infants.
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